Polypectomy techniques vary in clinical practice.
In this study, researchers from Indiana, USA, evaluated polypectomy practices in a random sample of gastroenterologists.
The team randomly selected 300 gastroenterologists from the membership directory of a professional society.
Subjects completed a standardized survey via telephone, e-mail, or fax.
Of the 300 gastroenterologists contacted, 189 participated in the study. Of these, 80% were in private practice, and 20% were in academic practice.
The mean number of years in practice was 15.5.
|69% of physicians used no method to prevent bleeding.|
The researchers found that forceps techniques dominated other polypectomy methods for polyps 1 to 3 mm in size. For larger polyps (7 to 9 mm) electrosurgical snare resection was the dominant technique.
The team did not identify a dominant method of polypectomy for polyps 4 to 6 mm in size.
The researchers found that 8% of physicians used dye spraying, 20% detachable snares, 20% clips, and 82% submucosal saline solution injection.
However, they also found that of those who had used submucosal saline solution injection, 30% had no rules for its use.
The team determined that for polyp stalks greater than 1 cm in diameter, 69% of physicians used no method to prevent bleeding. Of those who used preventive techniques, 76% used epinephrine injection.
In addition, the team found that the electrosurgical current used for polypectomy was pure coagulation in 46%, blend in 46%, and pure-cut in 3%; 4% varied the current.
Dr Navjot Singh and colleagues concluded, "At present, polypectomy technique among clinical gastroenterologists is highly variable".
"Some newer ancillary techniques have had extremely limited use thus far."